Multi-center Randomized Controlled Trial of Gastric Endoscopic Submucosal Dissection with or without Epinephrine Added Solution Young Award

Unsolved clinical questions exist in daily clinical practice similarly around the world. In gastric endoscopic submucosal dissection (ESD), epinephrine added injection solution (Ep-solution) is habitually used for preventing intraoperative hemorrhage, however, its usefulness is unknown. Our previous study suggested that the Ep-solution significantly reduced procedure time of gastric ESD (72 min vs 93 min, < 0.001). As we were aware that other Asian endoscopists had the same clinical question, we conduct an international multi-center randomized controlled trial to investigate effectiveness of the Ep-solution for reduction of gastric ESD time (NCT04032119). Four Japanese, one Hong Kong, one Korean, and one Singaporean institutions participated. The study protocol was drafted in Hong Kong and the kick-off meeting was held during JDDW2019. Minor revision of the primary study protocol took six months for approval from the institutional review board (IRB) in Hong Kong due to the Corona virus situation. Grant and data management were supported from the Asian Endoscopy Research Forum. After IRB approval at each institute, case enrollment started from March 2020 and the study is ongoing. An international collaborative study among Asian institutions is feasible as a practitioner oriented clinical research.